Miscellaneous Vehicle Registration

MISCELLANEOUS VEHICLE REGISTRATION AND SERVICE AGREEMENT

Recitals

WHEREAS Registrant Name: (hereinafter "Registrant") is the legal owner or authorized agent of the motor vehicle described herein; and

WHEREAS Registrar Name: (hereinafter "Registrar") provides vehicle registration processing, documentation, and related administrative services; and

WHEREAS the parties desire to record required vehicle information, declare accuracy of statements made, and set forth payment, term, confidentiality, and governing law provisions applicable to this registration and related services.

Registrant Information

Co-Registrant / Additional Owner (if applicable)

Vehicle Details

VIN:    Year:    Make:

Model:    Body Type:    Color:

Odometer Reading:    Title Number:

Purchase Date: Month Day Year

Personal    Commercial    Farm    Other:

Lienholder / Security Interest

Prior Registration and Transfer

Previous Registration State:    Previous Plate #:

Declaration, Odometer and Certification

The Registrant certifies under penalty of perjury that the information provided in this registration is true and correct to the best of Registrant's knowledge. Registrant further certifies that the odometer reading set forth above reflects the actual mileage of the vehicle stated unless otherwise noted.

I affirm that I am the owner or an authorized agent empowered to execute this registration:

Scope of Services

Payment Terms

Registration Fee Amount: $    Processing Fee: $

Payment Schedule:

Late Fee: . Any amount unpaid when due shall accrue the stated late fee and Registrant shall be responsible for collection costs and expenses.

Term and Termination

Term Commencement Date: Month Day Year

Term Expiration Date: Month Day Year

Either party may terminate this Agreement for cause upon written notice to the other party. Notice Period (days): . Upon termination Registrant remains liable for fees incurred through the effective date of termination.

Confidentiality

Each party agrees that all nonpublic personal information, vehicle data, financial details, and other confidential materials disclosed in connection with this registration and related services shall be held in confidence and used only for the purposes of completing registration, title transfer, lien recording, and related administrative functions. Confidential information shall not be disclosed except as required by law or with prior written consent of the disclosing party.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the state of: . Any dispute arising under this Agreement shall be subject to the exclusive jurisdiction of the state and federal courts located in that state.

Entire Agreement

This document, together with any attachments, schedules, and fee receipts executed contemporaneously, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior negotiations, understandings and agreements, whether written or oral. No modification shall be effective unless in writing and signed by both parties.

Certifications and Authorizations

Registrant authorizes Registrar to act as agent for the limited purpose of submitting registration and title documents, paying and collecting fees as designated herein, and receiving title and registration documents on Registrant's behalf. Registrant agrees to provide any additional documentation reasonably requested to complete processing.

Sign Now